Graston Technique®

Graston Technique® is a patented deep tissue treatment performed with specialty instruments. These instruments help detect tense tissue treat it with deep pressure and tactile focus. The use of Graston Technique® enables our physical therapy and chiropractic team to treat areas with unrivaled precision.

The technique uses flat stainless-steel instruments to scrape the outer layers of skin. This scraping stimulates blood flow and releases tension in muscle knots. Practitioners who wish to practice this technique are certified. Dr. St. Pierre is a certified Graston Technique® professional and has trained others in the technique.

Dry Needling

In my opinion, not all Dry Needling is the same. Most Physical Therapists and Chiropractors perform a “trigger point” Dry Needling technique which is painful and limited in scope. As all Dry Needling, we use an Acupuncture Needle to reach deeper soft tissue in your muscle and fascia. But, Trigger Point Dry Needling is often too aggressive and simply limited in effect.  Although I do perform the Trigger Point version of the technique, most of my needling technique is more gentle, comfortable and realizes that you’re more than a point, you’re a greater system of fibers, nerves and physiology. If I do perform a true “Trigger Point” technique, then I first perform other techniques to improve results and minimize discomfort. 

But, my preferred version of Dry Needling Therapy focuses more on your nervous system as a whole, utilizing the technique to calm things down, minimize soreness and promote a window of relief that your body will appreciate. It’s not equivalent to Acupuncture, which utilizes a different perspective and theory of our healing systems, yet my technique is also appreciated as more gentle approach. At one point in my education I did attempt an Doctorate level Acupuncture license while completing my Chiropractic degree, but realized that Acupuncture practice requires a level commitment that I wasn’t going to be able to meet. But I was so influenced that to this day I regularly receive 5- Element Acupuncture treatments myself. I simply use the science and the practice of needling, while honoring eastern principles of healing and wellness. So, I perform a deeper level of Sports Medicine Dry Needling which is more than a single trigger point or single problem, because the body is a more complex system than what medicine wishes us to believe. 

I feel most dry needling is swinging for the fences and you’re bound to strike out more often than hit a home run. I want to create a more meaningful effect on the body anyways, utilizing a neurologically and physiologically driven Dry Needling technique to compliment our other treatment strategies while creating a more solid and consistent effect.

If you’ve had Dry Needling that hurts then I encourage you to attempt a frankly more refined technique. 

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cupping therapy

Cupping therapy is refined therapy of an ancient technique where providers place vacuum cups on areas of the skin to create suction and release tension. Dr. St. Pierre uses handheld or electric vacuum pumps to create a strong pull which will help “unload” the tightness the muscle and fascia are holding. Although improved healing occurs with better blood flow to the tissue, it’s important that the “hickey” is not a bruise, but rather a “stain”. There is a difference and I feel most cupping being performed is too aggressive. The color of the mark will provide us information, data to determine where the healing potential is as it relates to your issue. But, a big but, there are more important things happening with cupping!

I’m not trying to move blood around or create a “hickey”, I’m trying to loosen the muscle by releasing the fascia that is vacuum sealing it. Fascial wrapping is like plastic wrap, it covers not only the outer muscle layers but is tied into ever fiber of your body, and delivers information to your brain and physiological processes to help maintain wellness. It’s an electrically conductive high-way of connective tissue that is essentially an extension of your brain. To me it is your brain, and most muscle pain is fascial pain, brain pain. If the tissue was healthier it wouldn’t cause the pain you’re experiencing. I had to personally figure this out after I broke my femur and had achiness, stiffness and muscle pain years later. This is where my perspective comes from, experience.

Fascia should really be reclassified as a nervous tissue, not connective tissue. So, if you can’t feel you’re own body because the fascia is so tight, then how are you going to manage your body’s healing processes within that same tissue? How are you going to train a tissue that isn’t responsive to what you throw at it in term of exercise, fitness and recovery? How do you stretch a brick? You can’t, and I feel we should be focusing on improving the quality of the tissue before trying to retrain it. Most people are trying to rehab tissue that is defensive and protective, not as responsive as it could be. This is why the rehab process athletes and the general public deal with is often slow and frustrating. When you stretch a muscle you’re not actually getting much length out of the fibers, rather you’re desensitizing the fascia for a short period of time. That’s why stretching needs to be performed so much. I think there is a better way. In the end, the best way to stretch a muscle is to use it, but it’s difficult if the myofascia is trying tied down tight. We can use cupping and other therapies to create more responsive system. It’s cheat mode for athletes…

Also, we know that a system that can’t feel itself experiences more pain, as evidenced by the narcotic epidemic in the country. Your brain wants to feel itself and if it can’t because it’s too tight it’ll the produce and experience pain syndromes that are exaggerated and not a true representation of how healthy the body might be. So, when I’m cupping I’m generally trying to help you “feel” the muscle fibers, let your brain experience the mobility and healing processes that are limited with the restrictive nature of the myofascia (muscle and fascia). This is why people often feel better during any activity, exercise, application of heat, massage and healing techniques, because they get to feel their body and their brain gets to process it’s self. It’s healthy to feel your body, and happens to help minimize and manage pain from a central nervous level.

Unfortunately, most soft tissue techniques like foam rolling and massage are compressive techniques not honoring the distractive or unloading needs the body requires. These techniques might help create some relief and loosen the tissue in the short term, but the Cupping combined with Graston Technique/Gua Sha is ideal to help unload and stretch the tissue in a more meaningful way. Either you’ll feel better because we legitimately loosened you up and you can feel yourself again, or you’ll now be responsive to exercise, massage and stretching strategies. I almost always perform gentle Graston Technique prior to cupping therapy.

I encourage all patients to learn how to perform these techniques at home. It might cost $50 investment in tools, but I’m happy to provide advise and direction on how to mimic what I do in the office. 

So, the two priorities with cupping both in the office or in home should be towards loosening the soft tissue and improving the body’s awareness of the tissue. Have you ever seen a sprinter punch their butt trying to wake it up?

Any provider utilizing cupping simply for “improved blood” to worse to create a “hickey” is doing a disservice to the patient. Cupping is another ancient technique which has been researched, refined and improved. Most of the beneficial healing potential doesn’t actually come from the blood, rather the brain, the nervous system and the physiological effect that occurs when you engage with it. Improving blood flow is a delivery system which can be limited if the myofascia is too tight and brain and body can’t feel itself. 


Keeping active is important for maintaining a healthy lifestyle. However, all athletes deal with a certain amount of post training muscle micro-trauma and exercise-induced inflammation.  Recovery from training associated trauma is a crucial component to maintain a healthy lifestyle. Athletes who do not adequately recover from training often end up with exercise-induced injuries. Muscle strains, swelling, and movement dysfunction are commonly among these injuries. Studies have found dynamic compression to be especially effective for post training recovery. It also helps accelerate recovery, reduce edema, promote lymph flow, and improve circulation. The NormaTec Recovery system uses dynamic compression to mimic the body’s natural muscle pump. All in all, NormaTec is a great tool to remove fluid and metabolites out of the extremities after a workout.

B-12 Injections

The providers at ESP recommend B-12 injections for people who are susceptible to B-12 deficiencies. This includes smokers, diabetics, aging populations, people with gastrointestinal disorders, and vegetarians/vegans. The benefits include improved red blood cell formation, bone health, mood, brain health, and energy.

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